Guangdong Province Key Laboratory of Pharmaceutical Functional Genes, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
MOE Key Laboratory of Gene Function and Regulation, School of Life Sciences, Sun Yat-sen University, Guangzhou, China.
Nat Med. 2023 Jun;29(6):1424-1436. doi: 10.1038/s41591-023-02369-6. Epub 2023 Jun 6.
Gemcitabine plus cisplatin (GP) chemotherapy is the standard of care for nasopharyngeal carcinoma (NPC). However, the mechanisms underpinning its clinical activity are unclear. Here, using single-cell RNA sequencing and T cell and B cell receptor sequencing of matched, treatment-naive and post-GP chemotherapy NPC samples (n = 15 pairs), we show that GP chemotherapy activated an innate-like B cell (ILB)-dominant antitumor immune response. DNA fragments induced by chemotherapy activated the STING type-I-interferon-dependent pathway to increase major histocompatibility complex class I expression in cancer cells, and simultaneously induced ILB via Toll-like receptor 9 signaling. ILB further expanded follicular helper and helper type 1 T cells via the ICOSL-ICOS axis and subsequently enhanced cytotoxic T cells in tertiary lymphoid organ-like structures after chemotherapy that were deficient for germinal centers. ILB frequency was positively associated with overall and disease-free survival in a phase 3 trial of patients with NPC receiving GP chemotherapy ( NCT01872962 , n = 139). It also served as a predictor for favorable outcomes in patients with NPC treated with GP and immunotherapy combined treatment (n = 380). Collectively, our study provides a high-resolution map of the tumor immune microenvironment after GP chemotherapy and uncovers a role for B cell-centered antitumor immunity. We also identify and validate ILB as a potential biomarker for GP-based treatment in NPC, which could improve patient management.
吉西他滨联合顺铂(GP)化疗是鼻咽癌(NPC)的标准治疗方法。然而,其临床疗效的机制尚不清楚。在这里,我们使用单细胞 RNA 测序和 T 细胞和 B 细胞受体测序,对匹配的、未经治疗和 GP 化疗后的 NPC 样本(n=15 对)进行分析,结果表明 GP 化疗激活了固有样 B 细胞(ILB)主导的抗肿瘤免疫反应。化疗诱导的 DNA 片段激活了 STING 型 I 干扰素依赖途径,增加了癌细胞中主要组织相容性复合体 I 类的表达,同时通过 Toll 样受体 9 信号诱导 ILB。ILB 通过 ICOSL-ICOS 轴进一步扩增滤泡辅助性 T 细胞和辅助性 T 细胞 1,随后在缺乏生发中心的三级淋巴样器官样结构中增强化疗后的细胞毒性 T 细胞。在接受 GP 化疗的 NPC 患者的 III 期临床试验(NCT01872962,n=139)中,ILB 频率与总生存期和无病生存期呈正相关。在接受 GP 和免疫联合治疗的 NPC 患者(n=380)中,ILB 也是预后良好的预测因子。总的来说,我们的研究提供了 GP 化疗后肿瘤免疫微环境的高分辨率图谱,并揭示了以 B 细胞为中心的抗肿瘤免疫的作用。我们还确定并验证了 ILB 作为 NPC 基于 GP 治疗的潜在生物标志物,这可能改善患者管理。